Percutaneous intervention in a patient with a rare single coronary artery arising from the left coronary sinus of valsava

A single coronary artery (SCA) arising from the sinus of Valsalva and supplying the entire heart is a rare congenital anomaly. According to the modified Lipton’s classification, R-1 is by far the most rare subtype of SCA, with an incidence of 0.0008% in patients undergoing coronary angiography. We present a case with an unreported anomaly, classified as Lipton R-I subtype, which initially followed the normal course of the right coronary artery. The posterior descending artery then proceeded as the distal and middle sections of the left anterior descending artery, while the posterolateral branch proceeded as the left circumflex artery and finally terminated as the proximal left anterior descending artery. The patient underwent percutaneous intervention in the posterolateral branch for an acute coronary syndrome.